Association between depression and asthma: insight from observational and genetic evidence

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BACKGROUND: Depression and asthma share several pathophysiologic risk factors, and their precise connection remains unclear. Our research seeks to assess the relationship between depression and asthma. METHODS: The association between depression and asthma was assessed through a multivariable logistic regression analysis, with data sourced from The National Health and Nutrition Examination Survey (NHANES) 2007-2018 and the English Longitudinal Study of Ageing (ELSA) 2004-2019. Subsequently, a linkage disequilibrium score regression (LDSC) analysis was conducted to evaluate the genetic correlation between depression and asthma. Moreover, a two-sample Mendelian randomization (MR) analysis was conducted by employing genome-wide association study (GWAS) summary statistics by means of both univariable MR (UVMR) and multivariable MR (MVMR). RESULTS: This study included 31,434 participants from NHANES and 17,021 participants from ELSA for observational research. In the unadjusted model, participants with depression had a significantly increased risk of asthma in comparison to participants without depression, both in NHANES (OR = 2.002, 95%CI: 1.827-2.193, P < 0.001) and in ELSA (OR = 1.753, 95%CI: 1.581-1.943, P < 0.001). After adjusting potential confounders, the results remain significant. The LDSC result revealed a significant positive genetic correlation between depression and asthma (rg = 0.352, P < 0.001).The UVMR results further substantiated a genetically predicted causality of depression on asthma (OR = 1.291, 95%CI: 1.157-1.442, P < 0.001), while the reverse causality does not stand. Similar findings from MVMR were obtained for the causality investigation after adjusting smoking (OR = 1.326, 95%CI: 1.156-1.520, P < 0.001), drinking (OR = 1.375, 95%CI: 1.186-1.593, P < 0.001), and education (OR = 1.425, 95%CI: 1.253-1.621, P < 0.001). CONCLUSION: Our findings indicate that depression may play a contributory role in the development of asthma, underscoring the potential benefit of implementing prevention strategies aimed at managing depression to mitigate asthma risk.

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